Provider Demographics
NPI:1194376475
Name:THOMAS THERAPY, PLLC
Entity Type:Organization
Organization Name:THOMAS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-383-8120
Mailing Address - Street 1:2457 WILD VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-6233
Mailing Address - Country:US
Mailing Address - Phone:662-822-6266
Mailing Address - Fax:833-901-0450
Practice Address - Street 1:363 HIGHLAND COLONY PKWY
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-6035
Practice Address - Country:US
Practice Address - Phone:662-822-6266
Practice Address - Fax:833-901-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty